Objectives: This study aimed to investigate the efficacy of postoperative submucosal injection of hyaluronidase (HUD) for reducing sequelae and quality of life (QOL) after mandibular third molar (M3M) surgery. Materials and Methods: Participants with bilateral impacted M3M underwent surgical extraction with a split-mouth randomized controlled study design. M3M were removed by the same surgeon in 2 sessions, one a control and the other experimental. Submucosal injection of HUD was performed in the experimental session and submucosal injection of saline in the control session. Mouth opening, facial swelling, and pain intensity were measured before surgery, and then 2 and 7 days after surgery. The QOL of participants following surgery was evaluated by means of a patient-centered outcome questionnaire (PCOQ). Results: A total of 36 patients was included in the final data analysis. There was a significant reduction in the maximal mouth opening and postoperative pain in the experimental side at the 2 and 7 days after surgery (P<0.05), and a remarkable difference in facial swelling was reported on the experimental side 7 days after surgery (P<0.05). The PCOQ demonstrated that participants reported less pain and swelling on the experimental side.
Conclusion:The present study provides clinical evidence that submucosal administration of HUD immediately after M3M surgery reduced postoperative discomfort and improved patients' QOL.
The present case series report aims to demonstrate the outcomes of sinus augmentation under perioperative pathologic conditions of the maxillary sinus. In a preoperative assessment, two patients were diagnosed with mucous retention cysts and chronic maxillary sinus, respectively. In two other patients, postoperative maxillary sinusitis was diagnosed via crestal and lateral approaches after the sinus augmentation. All cases were managed with supplementary medical or surgical therapy to minimize further complications of sinus augmentation. In one patient who refused referral to the tertiary hospital for asymptomatic chronic maxillary sinus, the opacification in the maxillary sinus recurred 18 months after augmentation. However, the abnormality was asymptomatic and still under surveillance. Three other patients presented no further complication and with favorable outcomes of sinus augmentation. In conclusion, bone augmentation in the maxillary sinus demands proper perioperative management to obtain clinical improvement.
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